RESUMEN
The SF-36 Health Survey and its 12-item abridged form is an instrument for the assessment of health related quality of life that can be used with healthy persons and patient populations. Its use has been recommended within a large German multicentre rehabilitation research programme. The paper examines missing data across all five study projects of the North German Network for Rehabilitation Research (NVRF) as well as psychometric properties of the instrument. In addition, data were compared to representative norm data using the SF-36 (SF-12) in the German National Health Survey. Results showed that there were few missing data in the SF-36. Examining the impact of age, gender and health status yielded effects of higher age and female gender on missing data. Psychometric analyses showed good to excellent results of the instrument in terms of scale fit and reliability. In terms of convergent validity, medium to high correlation of the SF-36 subscales with comparable instruments (e. g. SCL-90-R) could be found. Summarizing, the SF-36/SF-12 can be recommended for use in rehabilitation research. Analyses regarding sensitivity should be conducted in future studies.
Asunto(s)
Calidad de Vida , Rehabilitación/estadística & datos numéricos , Actividades Cotidianas/clasificación , Actividades Cotidianas/psicología , Adulto , Anciano , Diabetes Mellitus Tipo 2/rehabilitación , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Evaluación de Necesidades/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Psicometría/estadística & datos numéricos , Trastornos Psicofisiológicos/rehabilitación , Valores de Referencia , Reproducibilidad de los Resultados , Investigación , Factores SocioeconómicosRESUMEN
Type 2 diabetes is considered a multidimensional health impairment which includes several components like risk factors, cofactors and complications. The early and consequent therapy of all of these components reduces secondary complications. Instead of simply applying drug treatment, a more holistic concept including behavioural medicine therapy and empowerment of patients has been found much more effective. The facilities required for such a multifactorial therapy by different health care professions could easily be provided by the medical rehabilitation services available under the German pension insurance scheme. However, this emphasizes the demand for standardized protocols to achieve an objective allocation of rehabilitation services to individuals in need. In an epidemiological study on 12 429 working insurants (age 41 - 60 years) of the pension insurance fund in the region of Luebeck, persons suffering from type 2 diabetes were identified and evaluated regarding a need for medical rehabilitation. Therefore, an algorithm was developed quantifying the multidimensional disturbances which accumulate in type 2 diabetes mellitus. The following indicators are taken into consideration: risk factors like eating behaviour, lack of physical activity, smoking and stress; metabolic parameters such as HbA1c and plasma lipids; cofactors like hypertension and depression and, additionally, the acute complication of hypoglycaemia. Based on this rehabilitation score, 19 % of cases in a preliminary evaluation of 79 patients with type 2 diabetes showed a need for medical rehabilitation therapy.